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What is Menopause?
What is Menopause? Menopause refers to that time in every woman's life when menstruation ceases completely for one year. The ovaries decrease their output of estrogen and progesterone and women begin experiencing the effects of suboptimal levels of these hormones. In addition to signifying the end of a woman's ability to have children, declines in these female hormones affect the entire endocrine system. This process takes about three to five years to complete. Although time varies from woman to woman, menopause is generally completed by the time the woman reaches her early 50's.
As a woman approaches menopause and the years after, there are major changes that occur in her body, increasing her risk for many chronic diseases such as heart disease, diabetes, and osteoporosis. However, studies have shown that women who are good candidates for hormone replacement can actually prevent many of the chronic diseases that are seen with aging.
The remaining part of this newsletter will help you understand what Menopause does and whether you are a good candidate for hormone replacement. At the Institute we only use bio-identical hormones. These are hormones that are identical to your body so they are not perceived as foreign and thus are less likely to cause problems.
At the Institute we firmly believe in optimizing health and having a pro-active, preventative approach to health. To help patients achieve this, I have written a book called Your Guide To Optimal Health, Creating Your Personal Wellness Wheel. This book provides you step by step instructions to slow down aging and optimize health. The book has interactive exercises and tools to help you build your own Personal Wellness Wheel. This book is available on Amazon as well as in our office to help you begin the journey to Optimal Health!
Your Guide to Optimal Health
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Greetings!
The average American woman's life expectancy currently exceeds 81 years of age so most women can expect to live more than one third of their lives beyond childbearing years. Today, people speak openly about menopause and the effects. Billions of dollars are spent annually advertising to women targeting menopausal women.
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What to Expect at Menopause and Beyond
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 Every woman is unique but there are a number of side effects than can be generally anticipated. For some women these will feel like temporary nuisances, and for others, it can be disabling. The most important part is that the declines in a woman's hormones can seriously affect her physical and mental health as well as her prospects for longevity.
Hot flashes
This is the most common side effect associated with menopause. It feels like a sudden surge of heat through the body. Women can break out in a sweat, turn red, or begin to shiver as their body readjusts to the temperature. Some women will not experience these but for some, it can be disabling. The hot flashes are related to the declining levels of estrogen and can linger for years.
Vaginal/Urinary Tract Changes
As hormone levels decrease, the walls of the vagina become thinner, dryer, less elastic and more susceptible to infection. This condition can also make intercourse uncomfortable. Tissues in the urinary tract also change with the decrease of hormonal levels and can cause incontinence and an increased susceptibility to urinary tract infection.
Emotional Changes
Each woman is unique. For some, menopause can be a long awaited relief, and for others, a roller coaster of emotions, and for some, a depressing period. It is clear that hormonal decline is a major contributor to this emotional instability.
Osteoporosis
Osteoporosis affects both men and women, but it is more common in women. It is estimated that one out of two will suffer from some degree of osteoporosis. Women with a family history, history of steroid use, fair skin, and thin are more at risk. It is a gradual, yet debilitating condition in which bones become fragile, thin, causing loss of height and a predisposition to fractures. Building up bone density prior to menopause is the best strategy for the prevention of osteoporosis, but once menopause occurs, the best treatment is hormonal modulation. The National Institute of Aging has said, "Remarkably, estrogen saves more bone tissue than even large doses of daily calcium."
Cardiovascular Disease
Heart disease is the number one killer of American women. It is responsible for over half of the deaths of women over age 50. As estrogen levels decrease, LDL (bad) cholesterol increases and HDL (good) cholesterol decreases which increases the fat deposits on the artery walls predisposing women to heart disease.
In addition to reduction in estrogen and progesterone levels, testosterone and growth hormone are reduced during menopause. All of these can cause profound changes in breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, cardiovascular system, skin, brain, and energy levels. Women have about 1/10th the testosterone levels that men have. The waning of pre-menopausal levels of testosterone can be a contributing factor to a woman's loss of desire for sexual intercourse.
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Menopausal Symptoms |
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Hormone Modulation Can Help
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 Hormone therapy began in the 1940's and has been refined considerably over time. There are some contraindications to hormones such as breast and uterine cancer, but many physicians believe that there are some very strong benefits to hormone therapy:
Reduce osteoporosis
Reduce hot flashes
Reduce heart disease
Improve mood and well being
Improve muscle tone and more youthful look
Improve alertness, focus, and concentration
Increase energy and vitality
Improve libido
Reduce body fat
Each woman can be prescribed a unique program based upon her medical history, family history, life style, physical exam, laboratory studies, and other diagnostic studies.
How safe is Hormone Replacement?
There has been a lot of controversy recently based upon an article written in the Journal of American Medical Association that reported the results based upon the Women's Health Initiative Trial. The results of the trial linked Premarin and progesterone use to the development of health risks that the opinion of the authors felt exceeded benefits.
Many authorities believe this was a poorly designed study with many flaws. One of the major concern was Provera and Premarin are not bio-identical hormones of progesterone and estrogen. Premarin is made from horse's urine and contains only three compounds of many that match human estrogen. Another concern was that all patients received the same amount of estrogen with no consideration given to adjusting dosing based upon blood results. Finally, we could argue that there was a sex bias in the study. A similar study of men and testosterone replacement therapy based on the administration of non bioidentical hormones (obtained from ground up horse's testicles) would have been dismissed and viewed with great suspicion by the medical community, but this was not the case for the women's study.
We believe that bio-identical estrogen and progesterone replacement therapy that is performed in a controlled clinical setting where therapeutic levels are closely monitored and dosing adjusted can significantly improve a women's life.
The most recent literature that has re-evaluated the WHI study is stating that women between 50-59 actually BENEFITED from replacement in regards to heart disease. I feel the study was not able to show this the first time because they reviewed all the results simaltaneously without regards to age and medical concerns. I only provide treatment if you are a good candidate. I review your past medical history, family history and hormone status before we can talk about replacement. Call or email us today to see if you are a candidate for hormone replacement.
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Frequently Asked Questions |
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